CLIA Certification Number - Missing/Invalid

CARC/RARC Description
CO-16 Claim/service lacks information or has submission/billing error(s) which is needed for adjudication.
MA120 Missing/incomplete/invalid CLIA certification number.

 

Common Reasons for Message

  • CLIA certification number billed in Item 23 of CMS-1500 Claim Form (or electronic equivalent) was either missing or invalid
  • Incorrect qualifier was used on electronic claim

Next Step

  • Resubmit claim with valid CLIA certification number in Item 23 of CMS-1500 Claim Form
    • CLIA numbers are 10 digits with letter "D" in third position
  • Resubmit with valid qualifier or CLIA certificate number on Electronic Claim
    • Qualifier to indicate CLIA certification number must be submitted as X4
    • Review EDI training document on billing laboratory claims electronically

Claim Submission Tips

  • Apply for CLIA Certification prior to rendering lab services
  • Review codes that require a CLIA certification number
  • Qualifier is only required on electronic claims

View reason code list, return to Reason Code Guidance page.

 

Last Updated May 18, 2018